Provider Demographics
NPI:1932404399
Name:PLACER SURGERY GROUP INC.
Entity Type:Organization
Organization Name:PLACER SURGERY GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:RIDGEWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-652-4994
Mailing Address - Street 1:5001 AUBURN FOLSOM RD
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9420
Mailing Address - Country:US
Mailing Address - Phone:916-652-4994
Mailing Address - Fax:
Practice Address - Street 1:5001 AUBURN FOLSOM RD
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-9420
Practice Address - Country:US
Practice Address - Phone:916-652-4994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty